Professor, Discipline of Paediatrics and Child Health, University of Sydney

Disclosure statement

Heather Gidding receives funding from The National Health and Medical Research Council (NHMRC).

Kristine Macartney is the Director of the National Centre for Immunisation Research and Surveillance (NCIRS) which receives funding from the Australian and NSW Governments. She also receives funding from the NHMRC.

Aditi Dey does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

The World Health Organisation (WHO) has officially declared that Australia has eliminated rubella.

Rubella, also known as German measles, is a contagious viral disease. The symptoms in children are generally mild – fever, rash and sore throat – but infection during pregnancy can be devastating for unborn babies.

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But because most infections occurred during childhood and males were not vaccinated, the rubella virus continued to circulate, causing outbreaks. By the early 1990s there were still an average of 4,000 cases a year.

Achieving rubella elimination

Elimination is defined as “reduction to zero of the incidence of infection caused by a specific agent in a defined geographical area”. This means there can be no ongoing (also known as endemic) circulation of the virus in that area.

Australia was verified as having eliminated measles in 2014. We were able to “piggyback” our rubella elimination efforts onto those for measles by switching from the schoolgirl rubella program to a single-dose childhood measles-mumps-rubella vaccine (MMR) vaccine for both 12-month-old girls and boys in 1989.

From 1993, a second dose was added to capture those who missed the first dose or who weren’t fully protected.

Rubella symptoms are often mild in children, but if contracted during pregnancy, can be very dangerous for the unborn baby.From shutterstock.com

Verification of Australia’s rubella elimination status

As was required for measles, Australia had to submit a detailed report to the World Health Organisation, providing evidence that rubella had been eliminated. This included proof that most of the population is immune to rubella and that vaccine coverage is high. Showing low numbers of rubella and CRS cases was also important.

This evidence is backed up by a surveillance system that is sensitive enough to pick up and respond to cases when they occur and to test whether the rubella virus strain was circulating locally or imported from overseas. In the past three years, the cases of rubella identified were strains from overseas, rather than from a virus spreading within in Australia.

Elimination doesn’t mean eradication

Eradication only occurs when all countries in the world have achieved elimination of a disease. The only human disease to have been eradicated is smallpox in 1979.

No room for complacency

We need to maintain high coverage with our routine vaccination programs to ensure elimination is sustained, as rubella is still likely to be imported from other countries.

Travellers should have had two MMR vaccinations before going overseas. And every effort must be made to ensure new arrivals in Australia are up to date with their vaccinations, especially women of child-bearing age.

Finally, to eradicate rubella we need to support other countries in our region, and globally, to strengthen their control efforts.